Abstract
Abstract only
Introduction:
History of coronary stents is risk factor for short term adverse clinical events (ACE) after a non-cardiac surgery (NCS). Safety of Drug-Eluting Stent (DES) or Bare-Metal Stent (BMS) has been studied in such patients, but no clear optimal choice of stent type exists. Thus, we performed a meta-analysis to compare the two stents in patients undergoing NCS.
Methods:
PubMed, Medline, EMBASE databases were queried from inception to January 2018 for all studies comparing DES vs BMS in patients undergoing NCS. ACE was defined as 30-day event rate of myocardial infarction (MI) or death after NCS. Two subgroups created by difference in time from stent placement to NCS: Within 30-45 days and >45 days after stent placement. Random effect model was used to estimate the odds ratio (OR). Two tailed p value < 0.05 were considered significant.
Results:
Four retrospective cohort studies with 6708 patients were identified. Out of 2597 BMS patients, 8.9% had an ACE compared to rate of 6.5% ACE in DES patients (n=4111). In the overall cohort, there was no difference was observed with either stent type irrespective of duration of NCS after stent placement (OR: 0.85, 95% CI 0.70-1.03, P=0.46). In patients undergoing NCS shortly(30-45days) after stent placement, no significant difference in ACE was observed {Odds Ratio (OR): 0.90, CI 0.63-1.28, P=0.82}. Similarly, no difference was noted in ACE in patients undergoing NCS after 45 days of stent placement (OR: 0.88, CI 0.56-1.40, P=0.10).
Conclusion:
In patients undergoing NCS after coronary stenting, there is no difference in rate of ACE with BMS vs DES placement. Thus, choice of stent may not play a role in prediction of adverse clinical outcomes after an non-cardiac surgery.